Premature Retinopathy
is a condition characterized by abnormal blood vessel formation and fibrosis in the retina of children born prematurely before the vessels in the eye develop. Since there are no symptoms, babies born before 32 weeks and weighing less than 1500 grams should be examined by an experienced ophthalmologist. Treatment may include observation, laser, cryotherapy or surgery.
Glaucoma (Eye Pressure)
In glaucoma, known as eye pressure, the fluid pressure inside the eye increases and damages the optic nerve, which is necessary for vision. Glaucoma, which is often seen in people over the age of 40 and usually in both eyes, is a very common eye disease. It is one of the major causes of blindness, especially in older ages. Glaucoma is only noticed by many patients in the advanced stage and when significant vision loss occurs. Early diagnosis is very important, as there is no return after vision loss occurs.
Glaucoma is seen in 3 different types:
• Open Angle Glaucoma: It is the most common type of glaucoma in society. It does not show any symptoms in the early stages. It is insidious and progresses slowly over the years. As the disease progresses, vision and visual field losses occur, and it is no longer possible to reverse or cure optic nerve damage at this stage.
• Closed Angle Glaucoma: In some people, the angle area where the channels that drain the eye fluid are located is structurally narrow. For some reasons, the angle and channels completely close and eye pressure suddenly increases very much. In this case, very severe eye pain is felt, nausea and vomiting may occur. The eye becomes red, vision decreases. Patients see halos and rainbow-like colors around lights. In this case, called "Acute Glaucoma Crisis", an eye doctor should be consulted immediately; if treatment is delayed, vision is lost.
• Congenital Glaucoma: It is present from birth. Since the eye wall is flexible in babies, increased intraocular pressure causes the eyes to enlarge. Other symptoms include blurring, sensitivity to light and watering. Although tear duct obstruction is more likely in babies with watery eyes, these babies should also be examined for glaucoma.
Lazy Eye (Amblyopia)
is seen in early childhood. When one eye sees well and the other does not see at the same level, the eye with low vision is called "amblyopic". It is usually seen in one eye. Early diagnosis is important. Therefore, families should follow up on their children and eye examinations should not be neglected.
Cataract
Cataract is the loss of transparency of the natural lens in the eye. It is also called “curtain” or “white” in the public language. Cataract is the cloudy or opaque areas that form in the lens of the eye. The lens whose transparency is impaired becomes sooty, frosted or stained like glass and visual complaints begin. Objects are seen as shapeless, blurry or weak. Eye fatigue and headache occur. It should not be forgotten that these changes in the eye carry the risk of permanent vision loss. Medical treatment cannot eliminate cataract with medication, eye drops, exercise or glasses. Treatment is to replace the cataractous lens in the eye with a transparent intraocular lens through surgery. If the visual impairment is at a level that disrupts the person’s daily life, the cataract should be removed surgically. In congenital cataracts, surgery should be performed without delay in any case where vision is impaired.
Refractive Errors
There are 3 types of refractive errors in the eye:
Myopia: It is the state in which light rays focus in front of the retina for various reasons. Myopia is when the eyes see nearby objects clearly but cannot see distant objects clearly. Myopic people squint their eyes to see far away better. Myopia is usually hereditary. Using the eyes in low light or nutritional deficiencies can also cause myopia. Although it usually starts in the 8-12 age group, there is also adult-type myopia that occurs in the 20s.
Hyperopia: It is known as the inability to see near objects. In hyperopia people, the eyeball is usually shorter than normal. Therefore, it becomes difficult for the eye lens to focus the rays coming from nearby objects on the retina. In addition, the flatness of the cornea or the thinness of the eye lens can be the cause of hyperopia.
Hyperopia children usually see both near and far well because the focusing ability of the eye lens is strong enough to compensate for the shortness of the eye. Hyperopia can be seen together with strabismus in children. Non-visual symptoms such as headaches and lack of interest in reading in children can be signs of hyperopia.
Astigmatism: It usually occurs due to irregularity or distortion of the cornea. For normal vision, the cornea must be smooth and equally curved in all directions, but in astigmatism, the curve of the cornea is greater in one direction. It is hereditary and usually remains unchanged throughout life.
Retinal Tear and Retinal Detachment
The retina, which is the nerve layer that perceives vision in the eye, is normally attached to the inner wall of the eye. The gel-like vitreous that fills the back space of the eye shows weak adhesion with the retina layer. As a result of aging or some diseases, there is deterioration in the vitreous and it begins to separate from the retina layer. During separation, the patient may perceive “flashes of light”. Sometimes a tear develops in the retina during this separation. The patient may perceive “soot rain” or “darkness in front of the eye” at this stage. The fluid that passes behind the retina from this tear in the retina begins to separate the retina from the eye wall. This is called “rhetoric retinal detachment”. The risk is higher in myopes, those with a family history of retinal detachment, those who have undergone cataract surgery, and those who have retinal detachment in the other eye. In less common non-rhetoric retinal detachment, the cause may be the contraction of the membranes formed in the eye and pulling the retina into the eye (tractional) or fluid accumulation under the retina (serous).
When retinal detachment develops, there may be partial or complete loss of vision. When a tear or areas of thinning and deterioration that may cause a retinal tear are detected before retinal detachment develops, laser or freezing (cryotherapy) is applied to the area around this area. The aim here is to prevent the development of retinal detachment by ensuring that the retinal layer around the tear adheres more tightly to the eye wall. When retinal detachment develops, surgical treatment is required as soon as possible. Delaying surgery reduces the chance of success. Depending on the condition of the eye, silicone bands may be placed on the outer wall of the eye, gas injection into the eye (pneumatic retinopexy) or vitrectomy methods may be used during surgery. It may take a long time for vision to recover after surgery and the recovery may not be complete. Repeat surgery may be required in patients in whom the detachment does not fully recover.
Diabetic Retinopathy
Diabetic retinopathy, which develops due to diabetes, is the main cause of vision loss between the ages of 20-65. If left untreated, the risk of blindness is 25 times higher than in people without diabetes. The main cause of problems in the retinal layer is the deterioration of the retinal vessels due to diabetes. As a result of these deteriorations, microaneurysms (small blood vessel bubbles), hemorrhages, edema (accumulation of water), and exudates (accumulation due to leakage from the vessels) are seen in the early stages of the disease, while in more advanced stages, the nerve layer is not supplied with oxygen (ischemia), and new vessels and membranes are formed inside the eye. In the final stages of the disease, more serious consequences such as bleeding into the eye from these new vessels and the membranes separating the retina from the eye wall (retinal detachment) lead to blindness. Therefore, early diagnosis and appropriate follow-up and treatment are very important in these patients. Diabetic patients should be examined by an ophthalmologist when they are first diagnosed and should continue their check-ups as often as their doctor recommends, provided that no break is longer than one year.
Uveitis
Inflammation in the vascular layer of the eye is called “uveitis”. It can recur from time to time after treatment. Inflammations called “iridocyclitis” that occur in the front part of the eye respond early and well to treatment. Inflammations in the back part of the eye are called “posterior uveitis” and can lead to serious permanent vision loss. The causes of uveitis cannot be determined in most cases. In some cases, it may be accompanied by a rheumatic or infectious disease. Among these diseases; uveitis can also be seen with infectious diseases such as syphilis, tuberculosis, brucellosis, herpes, and AIDS, systemic diseases defined as collagen tissue and autoimmune origin (Behçet's disease, sarcoidosis, ankylosing spondylitis, rheumatoid arthritis, etc.). Uveitis shows symptoms as redness in the eye, inability to look at light, blurred or decreased vision, pain around the eye, and floaters. If the disease is in the central region, it mostly manifests itself as decreased vision.
Presbyopia (Old Eye)
Due to old age, people may have difficulty seeing nearby objects. This condition is called "presbyopia (old eye)". It is usually corrected with reading glasses, there is no cure.
Macular Degeneration
The macula (yellow spot) is a nerve layer located at the back of the eye that allows clear vision and activities such as reading, driving, etc. When the macula does not function adequately, blurriness is seen in the center of the visual field. During reading, words on the page become blurry and straight lines appear distorted. Macular degeneration is a common eye disease that occurs with age and is usually encountered in the group over the age of 60.
Strabismus
Strabismus (crossed eyes) is a condition in which the eyes look in different directions. It is usually seen in children, but it can also develop in adults. In strabismus, only one eye may be crossed, or the eyes may alternate and the gaze may shift. When there is a cross-eye, two different image perceptions will occur in the brain, leading to a decrease in the sense of depth in vision and the vision provided by both eyes. In adults, complaints of double vision are noticeable. A specialist ophthalmologist should definitely be consulted, especially for children with a family history of strabismus or amblyopia, and for babies whose eyes are noticed to have crossed eyes after the age of 4. In addition, routine eye examinations should not be neglected in every child starting at the age of 3.
Eyelid Disorders
Oculoplastic surgery is the medical branch that deals with eyelid, tear duct and orbital (eye socket) diseases. It covers eyelid inversion (entropion), eyelid outversion (ectropion), eyelid drooping (ptosis), eyelash inversion, opening of congenital or acquired tear duct obstructions, eye tumor surgeries and diagnostic and therapeutic studies related to eyelid spasm. Surgical interventions performed to correct eyelid sagging, which usually occurs due to hereditary factors and aging, are called “blepharoplasty”.
Drooping eyelid (ptosis) is the condition in which the upper eyelid level is lower than normal. Drooping eyelid (ptosis) can occur due to reasons such as congenital, after a blow, after eye surgery or muscle weakness at an advanced age. In cases of congenital eyelid lift, a sling must be used. In cases of ptosis that occur at an advanced age, the aim is to surgically shorten and strengthen the muscle that lifts the eyelid. Eyelash turning inward can cause symptoms such as scratching, stinging, tearing and pain in the superficial layers of the eye, and in advanced cases, it can cause scarring in the cornea and vision loss. In this case, the lid and eyelashes must be surgically turned outward and corrected. In cases of facial paralysis or when the lower eyelid turns outward, called “entropium”, the eye becomes open to external factors and firstly, drying and then infection occurs. Symptoms such as tearing, stinging and burning may occur. Surgical intervention restores the normal lid position. Involuntary tightening of the eyelids (blepharospasm) is the condition in which the muscles that close the eyelids contract excessively beyond the person’s will. It usually occurs after the age of 40. For treatment, Botox is first injected into certain points on and around the eyelid to prevent excessive contraction of the eyelid muscles. The duration of effect of the drug is usually 4-6 months. The treatment may need to be repeated at certain intervals.
